Asian Paints Registration Form.

ASIAN PAINTS LIMITED.
Registration Form
Full Name: …………………………………………………………………………………………...….

Passport Size Photo
Name of The Company: ………………………………………………………………………..….
Father/Husband Name: …………………………………………………………………………….
Gender: - Male Female
Category: - General SC ST OBC
Date of Birth: ……….../…………./………………
Permanent Address: ……………………………………………………………………………………………………………………
District: ……………………………………………………………………………………………………………………………………….
City: …………………………………………………………………………………………………………………………………………….
State: ………………………………………………………………………………………………………………………………………….
Pin Code: …………………………….………………………………………………………………………………………….…………..
Email Id: ………………………………………………………………………………………….…………………………………………..
Phone No: ……………………………………………………………………………………………………………………………..
Aadhar No: ……………………………………………………………………………………………….……………………………
PAN No: …………………………………………………………………………………………………………………………………

Shop Location Details.
Shop Name: ……………………………………………………………………………………………………………………….
Address: ………………………………………………………………………………………….…………………………….
District: ………………………………………………………………………………………………………………………….
State: ……………………………………………………………………………………………………………………………..
City: ……………………………………………………………………………………………………………………………………..
Pin Code: …………………………….…………………………………………………………………………………….………….
Bank Details.
Bank Account Holder Name: ………………………….…………………………………………………………………..…
Account Number: …………………………….………………………………………………………………………….……..….
IFSC Code: …………………………….…………… Bank Name: ………………………….……………………………………
Asian Paints Franchise Choose Option.
1. Dealership
2. Distributors
Land Area (Sq. Ft): …………………………………………………………………………………………………………………….
Ownership: - Owned Leased
Nature of Company: - Individual Partnership Pvt Ltd.
Last Turn Over: …………………………………………………………………………………………………………………..
How Much Funds Are You Billing to Invest.
1-10 Lakhs 10-20 Lakhs 20-30 Lakhs

Mode of Payment: - IMPS RTGS MOBILE BANKING
NEFT NET BANKING
Do You Have any Experience of Other Franchise?
If Yes then Give Details of Your Business.

………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
Name of the Company. Duration
1. ………………………………………………………… Year: …………………. To: …………………………...
2. ………………………………………………………… Year: …………………. To: …………………………...
3. ………………………………………………………… Year: …………………. To: …………………………...
Checklist for Enclosures

Please fill the application form carefully, for any help call helpline numbers.
Make sure Registration fee was paid after getting enquiry number.
Please provide only correct Information otherwise your application may
be Cancelled future.
DECLERATION
| We do here by declare that the information furnished here is correct to the best of my|
our knowledge and beliefs. For any incorrect information I misinformation furnished and
for noncompliance of the company’s policies formulated from time to time.
Date: - Signature of Applicant
Head Office: - 6A Shanti Nagar, Santacruz (East), Mumbai Maharashtra 400055 - India.
CIN:- L24220MH1945PLC004598 PAN: - AAACA3622K GST: - 27AAACA3622K1C6

Asian Paints Registration Form.

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ASIAN PAINTS LIMITED.

Full Name: …………………………………………………………………………………………...….

Father/Husband Name: …………………………………………………………………………….

Gender: - Male Female

Category: - General SC ST OBC

Date of Birth: ……….../…………./………………

Permanent Address: ……………………………………………………………………………………………………………………

Pin Code: …………………………….………………………………………………………………………………………….…………..

Email Id: ………………………………………………………………………………………….…………………………………………..

Phone No: ……………………………………………………………………………………………………………………………..

Aadhar No: ……………………………………………………………………………………………….……………………………

PAN No: …………………………………………………………………………………………………………………………………

Shop Name: ……………………………………………………………………………………………………………………….

Pin Code: …………………………….…………………………………………………………………………………….………….

Account Number: …………………………….………………………………………………………………………….……..….

IFSC Code: …………………………….…………… Bank Name: ………………………….……………………………………

Asian Paints Franchise Choose Option.

Land Area (Sq. Ft): …………………………………………………………………………………………………………………….

Ownership: - Owned Leased

Nature of Company: - Individual Partnership Pvt Ltd.

Last Turn Over: …………………………………………………………………………………………………………………..

How Much Funds Are You Billing to Invest.

1-10 Lakhs 10-20 Lakhs 20-30 Lakhs

NEFT NET BANKING

Do You Have any Experience of Other Franchise?

If Yes then Give Details of Your Business.

Name of the Company. Duration

1. ………………………………………………………… Year: …………………. To: …………………………...

2. ………………………………………………………… Year: …………………. To: …………………………...

3. ………………………………………………………… Year: …………………. To: …………………………...

Checklist for Enclosures

Date: - Signature of Applicant

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